Incomplete protection against hepatitis B among remote aboriginal adolescents despite full vaccination in infancy

Elizabeth Dent, Christine Selvey, Andrew Bell, Joshua Davis, Malcolm McDonald

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    The objective of this study was to determine long-term immunity to hepatitis B virus (HBV) in a cohort of adolescents who received plasma-derived HBV vaccine in 1989 and 1990 in a remote Australian Aboriginal community. This was done using a serological survey; primary outcome measures were cut-off titres of HBsAb, and the presence of HBcAb and/or HBsAg. Of 37 adolescents in the cohort, 4 (11%) had evidence of active infection, one with abnormal liver enzymes, 7 (19%) had evidence of past infection, 15 (41%) were HBsAb positive in low titre and 11 (30%) were classed as immune. It was concluded that there was relatively poor long-term serological immunity to HBV vaccination in this group; a finding which is in keeping with similar studies in Indigenous and remote populations elsewhere. This finding raises the concern that a significant proportion of Aboriginal adolescents in other remote communities (vaccinated in 1989 and 1990) were not adequately protected by the vaccine. If so, there will be an unexpected burden of chronic HBV infection in these settings and a substantial group who are non-immune, despite having received complete HBV vaccination courses as infants. The authors recommend followup serosurveys in remote Aboriginal communities to identify people with low HBsAb titres, especially those without an adequate anamnestic response to another dose of HBV vaccine. In addition, community-based active surveillance programs will be required to detect people with chronic HBV infection and provide access to monitoring and appropriate treatment.
    Original languageEnglish
    Pages (from-to)435-439
    Number of pages5
    JournalCommunicable diseases intelligence
    Volume34
    Issue number4
    Publication statusPublished - Dec 2010

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    Hepatitis B
    Hepatitis B virus
    Vaccination
    Hepatitis B Vaccines
    Chronic Hepatitis B
    Virus Diseases
    Immunity
    Hepatitis B Surface Antigens
    Infection
    Population Groups
    Vaccines
    Outcome Assessment (Health Care)
    Liver
    Enzymes

    Cite this

    Dent, Elizabeth ; Selvey, Christine ; Bell, Andrew ; Davis, Joshua ; McDonald, Malcolm. / Incomplete protection against hepatitis B among remote aboriginal adolescents despite full vaccination in infancy. In: Communicable diseases intelligence. 2010 ; Vol. 34, No. 4. pp. 435-439.
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    title = "Incomplete protection against hepatitis B among remote aboriginal adolescents despite full vaccination in infancy",
    abstract = "The objective of this study was to determine long-term immunity to hepatitis B virus (HBV) in a cohort of adolescents who received plasma-derived HBV vaccine in 1989 and 1990 in a remote Australian Aboriginal community. This was done using a serological survey; primary outcome measures were cut-off titres of HBsAb, and the presence of HBcAb and/or HBsAg. Of 37 adolescents in the cohort, 4 (11{\%}) had evidence of active infection, one with abnormal liver enzymes, 7 (19{\%}) had evidence of past infection, 15 (41{\%}) were HBsAb positive in low titre and 11 (30{\%}) were classed as immune. It was concluded that there was relatively poor long-term serological immunity to HBV vaccination in this group; a finding which is in keeping with similar studies in Indigenous and remote populations elsewhere. This finding raises the concern that a significant proportion of Aboriginal adolescents in other remote communities (vaccinated in 1989 and 1990) were not adequately protected by the vaccine. If so, there will be an unexpected burden of chronic HBV infection in these settings and a substantial group who are non-immune, despite having received complete HBV vaccination courses as infants. The authors recommend followup serosurveys in remote Aboriginal communities to identify people with low HBsAb titres, especially those without an adequate anamnestic response to another dose of HBV vaccine. In addition, community-based active surveillance programs will be required to detect people with chronic HBV infection and provide access to monitoring and appropriate treatment.",
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    Incomplete protection against hepatitis B among remote aboriginal adolescents despite full vaccination in infancy. / Dent, Elizabeth; Selvey, Christine; Bell, Andrew; Davis, Joshua; McDonald, Malcolm.

    In: Communicable diseases intelligence, Vol. 34, No. 4, 12.2010, p. 435-439.

    Research output: Contribution to journalArticleResearchpeer-review

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